Fever with rash differential diagnosis

The differential diagnosis for febrile patients with a rash is extensive. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion In contrast, brucellosis may be associated with only one or a few clinically subtle skin lesions. It must be emphasized that non-infectious diseases with skin rash can also present with fever and should be considered in the differential diagnosis. Drug adverse reactions occur in approximately 5% of patients The differential diagnosis of acute fever and rash in an adult is quite extensive and includes a variety of infectious and non-infectious causes. Infectious disease emergencies and diseases that can have public health implications can present as fever and rash Generalized rashes that manifest only as purpura or petechiae will not be discussed, with the exception of meningococcemia and Rocky Mountain spotted fever (because these conditions often present.. • Acute phase: high fever, rash, conjunctival hyperemia, cervical lymphadenopathy, redness of the oral and pharyngeal mucosa, strawberry tongue, and redness and swelling of the palms and soles. • Subacute phase >10 days: lower fevers, desquamation of the fingertips, thrombocytosis, arthralgia, and carditis

Evaluating the Febrile Patient with a Rash - American

Systemic symptoms, especially fever, can help narrow the differential diagnosis. 3, 4 Rashes accompanied by fever are most commonly associated with infections, but drug eruptions and rheumatologic.. Disseminated gonococcemia: The patient's fever, joint inflammation, skin rash, leukocytosis, and elevated ESR would support this diagnosis, but the adenopathy, hepatosplenomegaly, symmetric..

Fever With Rash In Adults Differential Diagnosis are a topic that is being searched for and favored by netizens these days. You can Get the Fever With Rash In Adults Differential Diagnosis here. Save all royalty-free pics. We Have got 11 images about Fever With Rash In Adults Differential Diagnosis images, photos, pictures, backgrounds, and more Cardinal Presentations This post is part of a series called Cardinal Presentations, based on Rosen's Emergency Medicine (8th edition). FeverWeaknessSyncopeAltered Mental StatusSeizureDizziness and VertigoHeadacheSore ThroatDyspneaChest PainAbdominal PainNausea and VomitingGastrointestinal BleedingAcute Pelvic PainBack Pain Causes of Fever Key Features Morbidity and mortality increase.

Fever and Rash - Infectious Disease Adviso

Mnemonic: Very Sick Person Must Take Double Eggs. V aricella (Chicken pox): 1st day (rash is often 1st sign in children) S carlet fever: 2nd day. P ox (Small pox): 3rd day. M easles (Rubeola or 14 day measles): 4th day (Remember: Koplik spots appear in pre-eruptive phase on 2nd day of fever) T yphus: 5th day. D engue: 6th day The differential diagnosis is extensive but self-limited illnesses predominate. Careful history and physical examination along with judicious use of laboratory testing and careful monitoring of the patient for new or changing symptoms usually elucidates a reason for the fever General Presentation Children frequently present at the physician's office or emergency room with a fever and rash. Although the differential diagnosis is very broad, adequate history and physical examination can help the clinician narrow down a list of more probable etiologies Target Audience and Goal Statement. This activity is intended for primary care clinicians, infectious disease specialists, and other clinicians caring for patients, particularly children, with fever, rash and other symptoms for which Rocky Mountain spotted fever and meningococcemia would be included in the differential

Fever and Rash - Infectious Disease and Antimicrobial Agent

DIFFERENTIAL DIAGNOSIS OF FEVER WITH RASH LESION PATHOGENS OR INFECTION a) Maculopapular rash: central distribution VRS - Measles, rubella, roseola, erythema infectiosum, EBV, echovirus, HBV, HIV BACT - Erythema marginatum, scarlet fever, erysipelas, 2° syphilis, leptospirosis, Lyme dzs, RICK - Rocky Mountain Spotted fever, Typhus OTH - RA, Kawasaki dis, drug rx Fever with Rash. 1. FEVER with RASH Dr ANAND NAMBIRAJAN ANAND. 2. Fever ‐an elevation of body temperature above the normal range of 36.5-37.5 °C (97.7-99.5 °F) due to an increase in the hypothalamic set point . (Harisson) Cause‐ 1. Pyrogens ‐ microbial products, microbial toxins (endotoxin), or whole microorganisms 2 DIFFERENTIAL DIAGNOSIS. The patient is a 23-year-old woman with a subacute illness characterized by spiking fevers, sore throat, rash, polyarthritis, leukocytosis, elevated ESR and CRP level, abnormal liver function tests, and an elevated serum ferritin level. The differential diagnosis includes infectious, rheumatic, and neoplastic etiologies If RMSF is treated with antibiotics aimed at another pathogen, the characteristic rash in RMSF may be mistaken for a drug eruption. Conditions to consider in the differential diagnosis of RMSF include the following: Meningitis. Meningococcemia. Q Fever. Rickettsialpox. Streptococcus group A infections. Streptococcus group B infections

RA is usually insidious. It begins with systemic inflammation, fever, malaise, anorexia, fatigue, weight lost, general aching and stiffness. Rationale: Jimmy John presents with joint swelling and tenderness in addition to fever, malaise and a rash. These symptoms are consistent with clinical manifestations of new onset rheumatoid arthritis There is a broad differential diagnosis for the presentation of fever and maculopapular rash in an adult. Although some causative conditions are benign, others are medical emergencies that require prompt diagnosis. We describe various conditions that result in a fever and maculopapular rash in adults Diagnostic Considerations. The overwhelming majority of cases of scarlet fever are caused by group A beta-hemolytic streptococci (GABHS). Other bacteria can cause a pharyngitis and similar rash, such as Staphylococcus aureus, Haemophilus influenzae, Arcanobacterium haemolyticum, and Clostridium species. [] The differential diagnosis includes other causes of fever accompanied by erythematous.

The Generalized Rash: Part I

  1. rash (commonly petechial and involving palms and soles, but may be maculopapular only), conjunctivitis, altered mental status, lymphadenopathy, peripheral oedema, hepatomegaly Buckingham SC, Marshall GS, Schutze GE, et al. Clinical and laboratory features, hospital course, and outcome of Rocky Mountain spotted fever in children
  2. Rash in Children - Differential Diagnosis; Fever and Injection Drug Use - Approach to the Patient; Splinter hemorrhages of infective endocarditis Fever and Rash - Approach to the Patient; Rash in Children - Differential Diagnosis; Fever and Injection Drug Use - Approach to the Patient; Palmar syphilis. View in Context: Secondary Syphilis.
  3. Differential Diagnosis of Dengue with Rash fever, headache, runny nose, and rash. Patient might complain of arthralgia. Fever, facial erythema or slapped cheek rash in first 1-4 days, followed by a generalized lacy rash that lasts 4-10 days and can be pruritic. Arthritis involving hands, feet or knees can be present, especially in.
  4. Approach to the diagnosis of the patient with fever and rash. In: The Skin and Infection: A Color Atlas and Text, Sanders CV, Nesbitt LT Jr (Eds), Williams and Wilkins, Baltimore 1995. p.296. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the.
  5. Usually mild - fever, rash, conjunctivitis, muscle and join pain, headache and malaise . differential diagnosis in the context of an undifferentiated febrile illness particularly i
  6. Viral hepatitis, leptospirosis, rheumatic fever, typhus, and mononucleosis can produce signs and symptoms that may be in the differential diagnosis of with Lassa fever in the early stages of infection
  7. Several conditions could mimic vasculitis 7,8,9 and need to be considered in the differential diagnosis depending on clinical presentation. Firstly, infection is a great mimic of vasculitis (see box 1). Several clinical and laboratory features are common to both vasculitis and infection

All children with fever and petechiae/purpura should be reviewed promptly by a senior clinician . History. Immunisation status - children <6 months of age or with incomplete immunisation status Rapid onset and/or rapid progression of symptoms and rash Patients with an erythematous rash plus fever are also at high risk for having a deadly diagnosis. Approach to the erythematous rash [2] Febrile & Positive Nikolsky's Sign: Patients in this group have the potential to be sick (Fever + Rash= Badness). But thy also have the potential to lose large amounts of skin which lead to fluid loss and. The differential diagnosis for febrile childhood petechiae with or without purpura includes a modest number of diseases. The conditions are traditionally separated pathophysiologically into acquired vascular, coagulation cascade, or platelet disorders. 17 An effective ED strategy is to separate the conditions by the presence or absence of toxic. The infectious exanthems to be considered in the differential diagnosis of roseola include : Rubella is characterized by simultaneous occurrence of low-grade fever and rash. The rash classically begins Petechiae may also be caused by noninfectious medical conditions. Examples include: Vasculitis. Thrombocytopenia (low platelet count) Leukemia. Scurvy (vitamin C deficiency) Vitamin K deficiency. Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis

  1. ation. Differential Diagnosis for Child with Fever: Acute Otitis Media. Scarlet fever. Sepsis. Gastroenteritis. Upper Respiratory Infection. Urinary Tract Infection. Meningitis
  2. Differential Diagnosis of Dengue with Rash Illness History Exam Tests Scarlet Fever (Group A beta-hemolytic streptococcus infection) • Occurs most commonly in children, 1-10 years, during the nonsummer months • Family gives history of abrupt onset of fever, sore throat, headache, malaise, and vomiting, 2-5 days post exposur
  3. Fever and rash is a relatively common presentation in travellers returning from the tropics, comprising around 4% of febrile 'syndromes' presenting to travel or tropical diseases clinics. 1 The presence of a rash as part of a febrile illness, although rarely pathognomonic, focuses the differential diagnosis. It is important to remember that rashes are common and may be caused by another.
  4. Computer diagnosis of the acutely ill patient with fever and a rash. Computer diagnosis of the acutely ill patient with fever and a rash Int J Dermatol. Jan-Feb 1973;12(1) :59-63. Diagnosis, Differential Drug Eruptions / diagnosis Enterovirus Infections / diagnosis.

The Generalized Rash: Part II

The differential diagnosis includes other maculopapular exanthems, such as measles, roseola, parvovirus B-19 infection and drug eruptions. The diagnosis of rubella can be made with IgM antibody. Differential Diagnosis I. Infectious mononucleosis. Rationale: Patients presenting with fever and swollen lymph glands with complaints of sore throat and recent fatigue provide rationale for this differential diagnosis. Infectious mononucleosis may begin slowly with fatigue, a general ill feeling, headache, and sore throat Fever and rash carries a broad differential diagnosis, especially in immunocompromised patients (see below). Often times the etiology is not obvious and workup involves cultures, skin biopsy, serologies, etc

Fever, Joint pain and Skin rash. WebMD Symptom Checker helps you find the most common medical conditions indicated by the symptoms fever, joint pain and skin rash including Viral pharyngitis, Lupus (systemic lupus erythematosus), and Phlebitis. There are 88 conditions associated with fever, joint pain and skin rash Khaled Alsaeid, Yosef Uziel, in Textbook of Pediatric Rheumatology (Seventh Edition), 2016. Erythema Marginatum. Erythema marginatum is characteristic of rheumatic fever and occurs in less than 5% of patients. This rash is nonpruritic and macular with a serpiginous erythematous border (Fig. 44-5).The individual lesions are about 0.4 cm in diameter and are usually located on the trunk and. This morning her mother noticed a rash on her hands and feet. The rash has not spread since that time. She is otherwise healthy. The review of systems shows her to be drinking less, not eating solid foods and she has no other rashes. She attends day care. The pertinent physical exam shows her to have a fever of 100.5 degrees F. She appears. It should be included in the differential diagnosis for any child with prolonged fever that is unresponsive to antibiotics. Diagnosis is often difficult in that the symptoms tend to present at different times. Usually a detailed medical history and multiple examinations (on different days) are needed to establish the diagnosis A drug allergy causes a rash that may occur several days or even weeks after taking a medication. It causes a mild, itchy, red rash and may be accompanied by a fever, an upset stomach, and small red or purple spots on the skin. Potentially life-threatening symptoms may include hives, a racing heart, swelling, itching, and trouble breathing

Fever, Rash, and Swelling: Don't Miss This Diagnosi

Differential diagnosis of very itchy skin. Is the itch localised or generalised? What is its distribution? Is there a primary rash or not? Erosions, crusting, bruising and infection can be due to excoriation and are of no help diagnostically 1. Joseph A. Zenel, MD* <!-- --> 1. 2. *Assistant Professor, Division of General Pediatrics, Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, OR. A 9-month-old girl is brought to the clinic because of worsening fever and rash. Three days ago, she developed a fever of 38.8°C (101.8°F) and pinpoint flesh-colored bumps on the abdomen. The rash soon turned. You have a fever with the rash. If this is the case, go to the emergency room. This could be caused by an allergic reaction or an infection. How to treat diaper rash · Poison ivy, oak, and sumac · Eczema · Lyme diseas

Differential diagnosis and management demand a skilful interpretation of clinical findings and pathological evidence. They are classified into infections, vasculitis, immunological aberration, leucocyte oxidase deficiency, hypersensitivity, chemicals, and neoplasia. granuloma. Th1 cell Generalised scaly rash present for <6 weeks with fever Scarlet fever. Scarlatiniform rash (redness then rough spots) Strawberry tongue; Peeling starts after 5 days of illness; Evidence of streptococcal infection; Kawasaki syndrome. Child aged < 14 years; Starts as morbilliform or erythematous rash; Swelling of hands and feet; Oral and ocular. The rash occurs in about 42 to 58 percent of children with a type of hereditary angioedema referred to as C1-INH-HAE, including newborns. This rare inherited disease occurs in about 1 in 50,000. Differential Diagnosis of Typical Measles Disease Agent Typical Season Typica l Age Prodrome Fever Duration of Rash (days) Rash Other Signs & Symptoms Measles Paramyxovirus Measles virus Winter, Spring 1 to 20 years 2-4 days of cough, conjuctivitis, and coryza High 5 - 6 Erythematous, irregular size, maculopapular; start

The Best 16 Fever With Rash In Adults Differential Diagnosi

Differential Diagnosis of Maculopapular Rash. Maculopapular rash may be mistakenly called macule, papule, patch, nodule, plaque, vesicle, or pustule. To differentiate these skin lesions from each other, here are the pictures of each. Picture 12: Macule measures less than 1 cm. It is a flat blemish like that of a freckle Well-appearing children without systemic symptoms or signs are unlikely to have a dangerous disorder. The appearance of the rash typically narrows the differential diagnosis. The associated symptoms and signs help identify patients with a serious disorder and often suggest the diagnosis (see Table: Some Causes of Rash in Infants and Children) 3 Differential Diagnosis. 3.1 Rash; 3.2 Vesiculobullous rashes; 3.3 Necrotizing rashes; 3.4 Petechiae/Purpura (by cause) 3.5 Erythematous rash; 3.6 Dark raised skin lesions; 4 Evaluation. 4.1 Rash visual diagnosis; 4.2 Erythematous rash; 4.3 Vesiculobullous rashes visual diagnosis; 4.4 Dark raised skin lesions; 5 Management; 6 Disposition; 7. Management of the Child with a Non-Blanching Rash Algorithm go straight to algorithm if patient unwell.. It is not uncommon for children to present to the Emergency Department with a non-blanching rash (accounting for approx. 2% of all attendances) +/- fever and other systemic features of illness. 1, 2 The minority of children with invasive bacterial infections, such as meningococcal disease. What is a differential diagnosis? Not every health disorder can be diagnosed with a simple lab test. Many conditions cause similar symptoms. For example, many infections cause fever, headaches, and fatigue.Many mental health disorders cause sadness, anxiety, and sleep problems.. A differential diagnosis looks at the possible disorders that could be causing your symptoms

Differential Diagnosis of Feve

Chickenpox is an illness that causes a red, itchy rash, fever, headache, sore throat, and body aches. Colon cancer. Colon cancer is often asymptomatic, but it can cause constipation, bowel obstruction, bloody stool and more. Erythema migrans. Erythema migrans is the name for the bull's-eye rash that occurs with Lyme disease. Amebiasi Scarlet fever is most common in children younger than 10 years, but it can affect adults as well. A 2-5 day incubation period precedes the onset of rash. Associated prodromal symptoms include fever and malaise. Sore throat and swollen, tender anterior cervical lymph nodes are typical. Abdominal pain, nausea, and vomiting are common in younger. The information on differential diagnosis of scarlet fever is based on expert opinion in the Public Health England (PHE) publication Guidelines for the public health management of scarlet fever outbreaks in schools, nurseries and other childcare settings [], and expert opinion in review articles on rashes [Ramsay, 2002; Watkins, 2008] and on scarlet fever [Holden, 2015; Basetti, 2017; DTB.

Scarlet feverTongue disorders

Rash - Wikipedia Approach to Patient with a Generalized Rash - NCBI - NIH The Generalized Rash: Part I. Differential Diagnosis - AAFP Papular Rash - an overview | ScienceDirect Topics Fever and Rash - Infectious Disease and Antimicrobial Agent In an infant presented with fever and rash, differential diagnoses are viral exanthema, some bacterial infections, immunologic reactions, and rheumatologic diseases. Our patient could not fulfill the criteria for toxic shock syndrome (TSS), and his blood culture (BACTEC) was negative


Clinically, the diagnosis of dengue fever is suggested by the presence of fever, severe headache, maculopapular skin rash, and myalgias associated with either the isolation or identification of DENV from serum, plasma, or tissue specimens, or by demonstration of a 4-fold increase of DENV antibodies in paired serum samples Fever accompanied by any of the following syndromes deserves further scrutiny, because it may indicate a disease of public health importance, where immediate infection control and containment measures are indicated: Skin rash with or without conjunctivitis (for example, measles, meningococcemia, hemorrhagic fevers such as Ebola Vesicular Rash Differential Diagnosis. The differential diagnosis of Vesicular Rash aims at distinguishing the disease from other ailments like Smallpox, Penis Herpes, Scabies or Herpes Zoster. Vesicular Rash Treatment. The treatment of Vesicular Rash usually involves curing the causative condition of the disorder Dengue fever must be differentiated from other diseases that prevent with flu like symptoms fever, retro-orbital headache, fatigue, joint aches or arthralgias ( joint aches ), myalgias ( muscle aches ), nausea / vomiting, and lymphadenopathy ( swollen lymph nodes ). Diseases with similar symptoms include influenza, measles, rubella, malaria.

The sandpaper rash and signs consistent with strep pharyngitis lead the physician to diagnose scarlet fever. The physician explains the diagnosis to the mother and oral Pen VK is prescribed. The boy feels markedly better by the next day, and the mother continues to give the penicillin for the full 10 days as directed to prevent rheumatic fever Differential diagnoses of urticaria include: Atopic eczema — lesions are usually accompanied by a greater degree of surrounding xerosis and erythema, and the rash typically lasts beyond 24 hours.For more information, see the CKS topic on Eczema - atopic. Contact dermatitis — eczematous rash, at any site related to a topical allergen, in a person of any age Search Results: Fever, Rash or multiple lesions, Diarrhea. Skip to main content Patient Findings Search Results Subscriber Sign In Feedback Select Language Share. Search for a symptom, medication, or diagnosis Picture 2 - Maculopapular rash Source - prime health channel.com. Maculopapular Rash Differential Diagnosis. One can diagnose maculopapular rash by first taking into account past illness or diseases. Then one needs to deeply inspect the site and extent of the rashes and see if they are itchy, painful or irritating

Click for pdf: Fever in the newborn period Definitions Fever is defined as a core body temperature greater than 38°C (100.4°F) in infants younger than 28 days and greater than 38.2°C in infants older than 1 month. Core body temperature is best estimated by rectal temperature. Fever is an extremely common pediatric presentation and has [ Fever + Rash Two big picture points for thinking about ddx For some reason I always thought this ddx was short. It's super long and interesting! Organize ddx based on whether the patient is immunocompetent or immunocompromised and specifically whether they have HIV Ddx for immunocompetent patients (asterisks indicate life-threatening Can't miss diagnoses) Infectious Bacteria The combination of fever and rash comprises an extensive differential diagnosis. Many of the causes of this presentation are life-threatening. In this article, rashes are categorized as petechial. Poster features six illustrations of children with diseases involving rashes, along with explanations of the diseases and close-ups of helpful diagnostic features. Diseases include measles, rubella, chickenpox, roseola, scarlet fever, and fifth disease. Allergic dermatitis is also addressed, though without any illustrations The most common rash illness likely to be confused with smallpox is chickenpox (varicella). Table 1 lists characteristics that may be helpful in differentiating the two illnesses. Some other illnesses and conditions to consider in the differential diagnosis are shown in Table 2. ALWAYS WEAR A PROPERLY FITTED N95 (OR HIGHER QUALITY) RESPIRATOR

D. Diagnosis: Toxic shock syndrome should be considered in cases involving unexplained fever associated with an erythematous rash and diffuse organ involvement, especially in menstruating women. Diagnostic criteria include: Fever > 38.9°C < 90 mm Hg systolic pressure; Rash with subsequent desquamation (especially palms and soles #### Differential diagnosis of rash and arthritis Several microorganisms can cause both a rash and arthritis, either by direct infection or by immune mediated mechanisms. Rheumatic fever is caused by an immune mediated response to group A ß haemolytic streptococcal pharyngitis

Search 4: Differential diagnosis of blanching macules, widespread distribution, arthralgias, and travel to Haiti (using VisualDx) For Patients: To understand the differential diagnostic process by using an age and body location diagnostic approach, try the Rash Skin Condition Finder. Part 5: Common and Serious Dermatologic Conditions Fever Y Y Y N Y Y Arthritis/arthralgia Y Y Y N Y N Proteinuria Y NY N Y N Rash (urticarial) Y Y N Y Y Y Eye symptoms Y Y NNY N Respiratory symptoms/cough Y Y Y N Y N *Clinical manifestations may not be present in all cases or at all stages of the disease. 1 Rare manifestations documented in limited cases. 2 ASA, NSAIDS, ACE-inhibitors The differential diagnosis of a rash should be based on the morphology of the lesion. To correctly categorize a lesion's morphology, the physician must first identify the primary lesion, the typical element of the eruption. This process can be complicated. Identifying the primary lesion may be difficult as it is often affected by secondary. Broaden Your Differential Diagnosis of Weakness in the Elderly. By. Melodie Kolmetz, MPAS, PA-C, EMT-P. -. 4.4.2016. Medic 77, please respond with BLS 1281 to a residential home for an elderly.

Drug rash with eosinophilia and systemic symptoms syndrome

a loss of appetite. diarrhea. a cough. runny nose. When the fever subsides, kids will usually develop a pink and slightly raised rash on their trunk (belly, back, and chest) within 12 or 24 hours. The differential diagnosis are rashes caused by scarlet fever are triggered, and viral infections such as measles or rubella exclude triggered rashes. therapy The most important measure is the immediate discontinuation of the drug in question, possibly with the preparation of a drug from a different group of active ingredients, in order to Diagnosis and Treatment. A doctor usually knows your child has roseola because of the telltale symptoms: high fever followed by rash. Usually, no lab tests are needed Staph Scalded Skin Syndrome (SSSS) Pathogenesis: Infection by S. aureus phage group II (types 55 and 71) at distant site→ produceexfoliatoxins A and B (ETA and ETB) →exfoliatoxins disseminate via bloodstream widespread cleavage of desmoglein 1→diffuse subcorneal acantholysis Clinical features: Children esp those with ↓renal clearance (low mortality <5%) > The rash of roseola that follows a high fever is unique, and often the diagnosis is made simply on physical examination. Aspirin and the Risk of Reye Syndrome in Children Do not give aspirin to a child without first contacting the child's physician

A teenager with fever, rash and arthritis | CMAJMaculopapular Rash - Pictures, Causes, TreatmentGeneralized Annular Skin Lesions - Photo Quiz - American

Fever with polyarthritis and rash encompasses a large number of differentials which may include infectious causes, e.g., dengue, chikungunya, viral hepatitis, TB, etc., and autoimmune conditions. Low-grade fever; Symmetrical rash on the back of the legs, buttocks and arms (Figure 1) The macular rash begins as erythematous and then becomes purpuric and raised. Figure 4. Henoch Schonlein purpura Differential diagnoses. In young children, consider intussusception which also presents as bloody diarrhoea and abdominal pain. Intussusception. The combination of fever and rash in a young patient can strike fear in the heart of a pediatrician. Most often, however, the child looks well and has a viral exanthem. The physician, quite correctly, does not even consider meningococcemia or other dreaded illnesses in the differential diagnosis It usually infects kids between 6 months and 2 years old. It often starts with several days of sore throat, runny nose or cough, and a high fever. A rash of reddish flat or raised spots often follows Diagnosis: Hereditary C2 deficiency with associated cutaneous lupus erythematosus and pyogenic infections. Histopathologic findings and clinical course The biopsy specimen displayed minimal hyperkeratosis with mild focal basilar vacuolopathy and rare necrotic keratinocytes, as well as an angiocentric, mixed-cell, superficial inflammatory.